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Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants
dc.creator | Todorović-Balint, Milena | |
dc.creator | Bila, Jelena | |
dc.creator | Balint, Bela | |
dc.creator | Jeličić, Jelena | |
dc.creator | Đunić, Irena | |
dc.creator | Antić, Darko | |
dc.creator | Kraguljac-Kurtović, Nada | |
dc.creator | Vujić, Dragana | |
dc.creator | Mihaljević, Biljana | |
dc.date.accessioned | 2022-09-21T13:07:56Z | |
dc.date.available | 2022-09-21T13:07:56Z | |
dc.date.issued | 2020 | |
dc.identifier.issn | 0042-8450 | |
dc.identifier.uri | http://rimi.imi.bg.ac.rs/handle/123456789/1256 | |
dc.description.abstract | Background/Aim. Autologous stem cell transplants (ASCTs) improve the rate of overall survival (OS) in patients with hematological malignancies such as multiple myeloma (MM) after induction chemotherapy, aggressive non-Hodgkin's lymphomas (NHL), and relapsed, chemotherapy-sensitive Hodgkin's lymphoma (HL). The study aim was to evaluate influence of applied CD34+ cell quantity on clinical outcome, as well as early post-transplant and overall survival (OS) of HL and MM patients following ASCT. Methods. This study included a total of 210 patients (90 HL/120 MM) who underwent ASCT. Stem cell (SC) mobilization was accomplished by granulocyte-colony stimulating factor (G-CSF) 10–16 μg/kg body mass (bm) following chemotherapy. For proven poor mobilizers, mobilization with G-CSF (16 μg/kgbm) and Plerixafor (24 or 48 mg) was performed. To our best knowledge, it was the first usage of the Plerixafor in our country in the ASCT-setting. Harvesting was initiated merely at "cut-off-value" of CD34+ cells ≥ 20 × 106/L in peripheral blood with "target-dose" of CD34+ cells ≥ 5 × 106/kgbm in harvest. The CD34+ cell count and viability was determined using flow cytometry. Results. The majority of HL patients (76.7%) were infused with > 5.0 × 106/kgbm CD34+ cells, while 68.3% of MM patients were treated by approximately 4.0–5.4 × 106/kgbm CD34+ dose, respectively. Beneficial response (complete/partial remission) was achieved in 83.3% (HL) and 94.2% (MM) patients. Among parameters that influenced survival of HL patients with positive response to the therapy, multivariate analysis (pre-ASCT performance status, CD34+ cell quantity applied, rapid hematopoietic, i.e. lymphocyte and platelet recovery) indicated that higher CD34+ cell dose used, along with pre-ASCT performance status correlated with superior event-free survival (EFS) and OS following ASCT. In MM patients, multivariate analysis (renal impairment, infused CD34+ cell quantity, early platelet recovery) indicated that the number of CD34+ cells infused was the most important parameter that influenced both EFS and OS after ASCT. Conclusion. Data obtained in this study undoubtedly confirmed that CD34+ cell dose applied is an independent factor that may contribute to superior clinical outcome and OS of HL and MM patients following ASCT. | |
dc.publisher | Military Medical Academy | |
dc.relation | info:eu-repo/grantAgreement/MESTD/Integrated and Interdisciplinary Research (IIR or III)/41030/RS// | |
dc.relation | info:eu-repo/grantAgreement/MESTD/Integrated and Interdisciplinary Research (IIR or III)/41004/RS// | |
dc.rights | openAccess | |
dc.rights.uri | https://creativecommons.org/licenses/by-sa/4.0/ | |
dc.source | Vojnosanitetski pregled | |
dc.subject | hematologic neoplasms | |
dc.subject | stem cells | |
dc.subject | transplantation | |
dc.subject | autologous | |
dc.subject | survival | |
dc.subject | flow cytometry | |
dc.title | Influence of applied CD34+ cell dose on the survival of Hodgkin's lymphoma and multiple myeloma patients following autologous stem cell transplants | |
dc.type | article | |
dc.rights.license | BY-SA | |
dc.citation.epage | 851 | |
dc.citation.issue | 8 | |
dc.citation.spage | 844 | |
dc.citation.volume | 77 | |
dc.identifier.doi | 10.2298/VSP180808160T | |
dc.identifier.fulltext | http://rimi.imi.bg.ac.rs/bitstream/id/2827/Influence_of_applied_CD34+_cell_dose_pub_2020.pdf | |
dc.type.version | publishedVersion |